Extended Health Care Survey Details

EHC Survey 2021: Details and Explanations

How the EHC Satisfaction Survey Was Conducted

Members of BCRTA were invited to participate in a survey about their personal experience with EHC plans. The invitation to participate was circulated widely: by email in our Connections newsletter, by announcement on our website, and through the distribution of the EHC Survey form in our Summer 2021 issue of PostScript magazine.

An online form was made available for easy submission of ratings and comments. We received hundreds of paper submissions as well. The paper submissions were carefully transcribed by BCRTA staff into the same form used by those submitting online.

Steps were taken to minimize duplicate entries.

We received over 1,100 entries, which together represent over 31,000 data points. More than 1,000 comments were submitted across five distinct areas of the EHC plans. All of the comments submitted by users are available below. Those comments have been compiled into ten reports (five for Green Shield and five for Johnson) and total nearly 100 pages.

Statistical Significance

The results of our survey have statistical validity. We received 1,117 valid entries. The online form required certain questions to be answered in order to proceed. This provided certainty that we had accurate information. We rejected paper submissions that did not answer required questions such as “Who is your plan provider”. There were only five rejected submissions.

A handful of individuals submitted surveys with answers about other plans that were not the TPP sponsored Green Shield plan or BCRTA Johnson plan. Those submissions do not factor into our results.

Our overall statistical significance is calculated to be within 4%, 99 times out of 100. Where we use smaller subsets of data we note the statistical significance for that subgroup.

Confidence intervals are the “plus or minus” amounts around a finding. An example is given just above, when we say that results will be within 4%, 99 times out of 100. The larger the number of respondents, the more likely the results are to closely reflect the opinions of the larger group. BCRTA’s membership is 17,000, not all of whom have EHC coverage. Our large group of 1,117 respondents far exceeds the threshold required for a typical poll which would aim to be within 5%, 95 times out of 100.

As noted in the main survey report, the accuracy of results for Green Shield are higher than those of Johnson, but both are statistically significant. We have the exact numbers of Johnson EHC plan participants and used those to calculate statistical probability for that subgroup. For the Green Shield users, we took the maximum possible number of BCRTA members who might be on that plan as the number to work with – the most conservative approach.

To learn more about sample sizes and calculating statistical significance, view this page that has a handy calculator: https://www.surveysystem.com/sscalc.htm

Overall Satisfaction Ratings – Calculation

Survey respondents were asked to rate their provider on a scale of 1 to 5, with 1 being Poor and 5 being Excellent. The rating results are a simple average.

Johnson

4.12

Green Shield

2.97

Net Promoter Score – What it is, Formula, What it means

The Net Promoter Score (NPS) is a method of demonstrating the relative proportion of promoters of a product versus detractors. Promoters are satisfied clients who gladly share their positive experience with friends. Detractors are dissatisfied, and tend to speak poorly of their experience.

NPS can be calculated using either a five-point or ten-point rating system. When using a rating scale of 1 to 10, all ratings of 9 and 10 count as promoters. Ratings of 7 and 8 are classified as neutral. Ratings 1 to 6 are classified as detractors.

So, for example, if an organization has 25% ratings in the 1-6 range, 25% ratings of 7-8 and 50% ratings of 9-10, their NPS would be:

50% promoters MINUS 25% detractors = PLUS 25

On the other hand, if they had 50% detractors and 25% promoters, the formula would be:

25% promoters MINUS 50% detractors = MINUS 25

Our EHC Satisfaction Survey uses a 1 to 5 rating system. The most common way to calculate NPS using a five-point rating system is to consider 4 and 5 ratings as promoters and ratings from 1 to 3 as detractors. The formula is similar to the ten point system, except there are no neutrals. This makes sense, as it would be rare for us to positively recommend a product or service which we rated only 3 out of 5.

So here is a summary of the overall ratings for GSC and Johnson Prestige from our survey.

We can see a clear trend in the ratings. Johnson ratings are heavily weighted to the positive. Green Shield has many more negative ratings.

Let’s look at Green Shield’s ratings and calculate the NPS for GS. Ratings 4 and 5 are promoters, 1 to 3 are detractors.

Green Shield NPS calculation:

35.7% Promoters MINUS 64.3% Detractors = MINUS 28.6

Let’s turn to the Johnson Prestige ratings and NPS.

Johnson Prestige NPS calculation:

80.4% Promoters MINUS 19.6% Detractors = PLUS 60.9  

So now let’s compare the two scores side by side:

What is a typical Net Promoter Score?

A recent global survey found that the average Net Promoter Score of 150,000 organizations was PLUS 32.

For more info on Net Promoter Scores, visit:

Would You Recommend This to a Friend?

Chances are that you discuss important choices with your friends. We’ve all been part of conversations where someone says, “You have to check out that new restaurant.” We wouldn’t say that if we did not think the restaurant was good, or even if it was just average. We have to feel good about a product to put our name behind it, especially if we want our friends to have a good experience. After all, they will remember that we told them it was good! So this question of recommendation is an excellent litmus test for how we truly feel about a product or service. For something minor like a restaurant recommendation, a difference of opinion is not of great consequence. But the provision of Extended Health Benefits makes a much more significant impact on a person’s sense of well-being and involves a greater investment. For that reason, we view the answer to this question as very significant.

Just over a third of Green Shield users (35.2%) would recommend that other retirees use Green Shield. By contrast, about nine out of ten (88.9%) Johnson users are happy to recommend their Prestige plan.

Green Shield users are nearly six times as likely to NOT recommend the experience. 64.8% of GS users do NOT recommend their plan versus only 11.1% of Johnson users.

Prescriptions Coverage Satisfaction

Compared to Green Shield users, Johnson users are happier with the prescription fulfillment process, have fewer problems with claims, and are more likely to be satisfied with the resolution of problems.

Our survey gave participants an opportunity to leave a comment about the process if they had any issues with prescriptions. We received a large number of comments regarding prescriptions, particularly from Green Shield users. There are more Green Shield users than Johnson users, so that might begin to explain the difference. But the clear trend in the data and in the comments is that GS users are more likely to have problems with claims, the problems seem to be more intractable, and the dissatisfaction with how problems are addressed is intense. Only 16.8% of Green Shield users with prescription claim issues were satisfied with Green Shield’s response.

Nearly half of Green Shield users (45.1%) reported problems with claims, and a large portion of those problems involved paperwork and process. A third of Johnson users faced issues, but the theme with those users tended to be about coverage of drugs not in the BC Pharmacare formulary. Johnson users were more than twice as likely to be satisfied with explanations regarding claims that did not go through (37.8% satisfied with Johnson vs. 16.8% satisfaction for Green Shield users).

Comments about prescription coverage

Because respondents who reported issues with coverage were asked to comment, the comments come primarily from individuals who have struggled to have claims paid. With this as a starting point there are few comments praising either plan. However, the more problems there are in an area, the more likely there are to be comments.

Please note the disclaimers on the comment report – these are user comments which express the user’s point of view and their perception of the plan. Comments are the views of individual retirees and are their own; comments do not necessarily represent the opinions of BCRTA.

Paramedical Coverage Satisfaction

Users on both plans report fewer issues with paramedical claims than with prescription claims.

Johnson’s rating of 4.4 out of 5 is the highest rating of either provider in any category. There are just a handful of issues from Johnson users, often about setting up the claims process with a new provider.

Green Shield users give their plan 3.7 stars, which also happens to be the highest rating GSC achieves in any category. However GSC users are more likely to experience claim difficulties and are significantly less likely to be satisfied with how the problems are resolved (22.2% GSC versus 52.9% Johnson).

The comments are instructive as to how users perceive their plans.

Comments about paramedical coverage

Because respondents who reported issues with coverage were asked to comment, the comments come primarily from individuals who have struggled to have claims paid. With this as a starting point there are few comments praising either plan. However, the more problems there are in an area, the more likely there are to be comments.

Please note the disclaimers on the comment report – these are user comments which express the user’s point of view and their perception of the plan. Comments are the views of individual retirees and are their own; comments do not necessarily represent the opinions of BCRTA.

Vision, Hearing and Equipment Coverage Satisfaction

All users would like higher dollar values available for coverage. Just 11.5% of Johnson users had any issues at all (versus 21.5% GSC), and of that small group of Johnson users who have any issues, 42.9% were able to resolve this issue to their satisfaction (versus just 19.6% GSC).

Comments about vision, hearing and equipment coverage

Because respondents who reported issues with coverage were asked to comment, the comments come primarily from individuals who have struggled to have claims paid. With this as a starting point there are few comments praising either plan. However, the more problems there are in an area, the more likely there are to be comments.

Please note the disclaimers on the comment report – these are user comments which express the user’s point of view and their perception of the plan. Comments are the views of individual retirees and are their own; comments do not necessarily represent the opinions of BCRTA.

EHC Support

Having someone help you makes all the difference. There are several comments from retirees about what a difference it made when an individual in the insurance company helped resolve an issue. There are instances where both plans receive praise in this regard. However, there is a very marked trend for Green Shield users to be less satisfied with the support they received. As noted in the main report, Johnson users who received support reported higher satisfaction overall with their plan, but GS users who asked for support ended up giving their plans a lower rating than those who never asked for support.

Accessing Support

One remarkable statistic is that less than half of all EHC users (both plans) ever asked for support! For some this was because everything worked well – a good sign. But there also is perhaps a trend to avoid dealing with the “hassle” of sorting out claims. A frequent comment, particularly from older retirees, was that working through problems took more energy than they had. Many did not seek help with problems at all, and many reported that they gave up trying when their first efforts were not successful. On this point the financial interests of the user and the provider are directly opposed.

Technology – Benefit or Not?

Retirees are not as conversant with high tech gadgets and online solutions as younger groups. The recent trends toward advanced technical solutions for support being adopted by business are therefore not as effective as one might hope – at least from the consumer’s point of view. More efficient customer service systems do not necessarily reflect a better experience for consumers, as noted in this recent Harvard Business Review article. Difficulty with online support is a frequent complaint we receive from our members, both for EHC plans and for other services. There is a continuing trend in both business and government to move to service automation, even for vulnerable seniors. It is an issue that BCRTA is watching closely.

In this regard, Johnson’s reliance on human interaction for customer service turns out to be an unexpected blessing. Johnson does not have a smart phone app. Users generally cite Johnson’s website as a weakness, not a strength, but are full of praise for the telephone support and helpfulness of agents.

Comments about support

Because respondents who reported issues with coverage were asked to comment, the comments come primarily from individuals who have struggled to have claims paid. With this as a starting point there are few comments praising either plan. However, the more problems there are in an area, the more likely there are to be comments.

Please note the disclaimers on the comment report – these are user comments which express the user’s point of view and their perception of the plan. Comments are the views of individual retirees and are their own; comments do not necessarily represent the opinions of BCRTA.

Dental Coverage Satisfaction

Only 3.6% of Johnson users did not find the dental claims process easy – fully 96.4% said it was a breeze. Achieving a near-perfect score is remarkable, yet this is also the lowest rating for Johnson in any category: just 4.0 out of 5. Why? Dental coverage for retirees is not as generous as dental coverage was during your working years, where employers paid up to 80% of the premium costs. Users seem to note this difference and are less satisfied with coverage overall. However the lack of claims problems for Johnson users shows up in the small number of comments: only six persons on the Johnson plan left comments, versus 101 on the GSC plan.

The satisfaction levels from Green Shield users are significantly lower, with over a third having problems having claims paid. Apart from some complaints from dentists that the paperwork was too difficult for them (the dentists), the GS automated process seems to work well: 88.5% of Green Shield users said the dental claims process was easy for them – the best result for GSC in any category.

Comments about dental coverage

Because respondents who reported issues with coverage were asked to comment, the comments come primarily from individuals who have struggled to have claims paid. With this as a starting point there are few comments praising either plan. However, the more problems there are in an area, the more likely there are to be comments.

Please note the disclaimers on the comment report – these are user comments which express the user’s point of view and their perception of the plan. Comments are the views of individual retirees and are their own; comments do not necessarily represent the opinions of BCRTA.

Dealing With Possible Objections to This Survey

Are satisfaction surveys valid? There are a few questions that arise, and here are some responses.

Do the answers represent the overall sentiment of the members?

The survey has statistical validity as noted above.

Aren’t angry people more likely to respond?

We’re not sure, but it is likely. The survey responses are voluntary submissions by people who were motivated to respond. Perhaps angry people are more likely to move into action, that’s human nature. But that does not advantage one plan over the other. Both Green Shield and Johnson users all share in that property of having human nature. We think it reasonable to think that people who have something to complain about will do so no matter who their provider.

Are Johnson plan results better because it is smaller?

It is true that there are fewer retirees on the BCRTA Johnson plan that the Green Shield plan. That is mostly a function of two things: most users signed up for the default plan before the BCRTA option existed, and many have never understood that the BCRTA-Johnson option is available to them.

Our plan is growing and continues to offer the highest level of service and quality. Thousands of BCRTA members are currently using the EHC, home and travel insurance options crafted by BCRTA and Johnson. The survey results show clearly that we provide a good experience for subscribers.

Is there a limit to how many more retirees we can take on? In a word, no. Our partner Johnson already has an annual turnover of nearly $2 billion in premiums and has hundreds of employees across Canada, including a team based right here in BC. The choice for the service to be personal and attentive is part of the culture of our group and the mandate BCRTA has given to our provider. That commitment will never change.

Are you running the survey to get more users on your plan?

By its nature a survey is not promotional – it is factual. Are we confident that our plan will fare well in an open discussion amongst retirees about their experience? You bet. This survey shines a light on to the real world experience of retirees. But as to what happens next, it’s about choice – finding the plan that fits your needs. Many retirees are unaware that they have those options, and feel stuck and dissatisfied.

BCRTA is a non-profit member-led organization, and our purpose is to serve the well-being of our members. That includes making them aware of the options available for EHC coverage. We field queries and comments about EHC coverage each and every day. Our goals for EHC are to provide a well-run plan that has service to members as a priority. Our plan might be the perfect fit for you, but for some individuals the best choice might be another plan.

But should you make a choice without knowing what it is actually like to be on that plan? Retirees can make their best choices when they are fully aware of the coverage offered, and also what the claims experience and support quality is like for real-world clients like them.

When you can see the plan terms and what the plan experience is, you are most empowered to make the choice that is right for you, and we think that is the way it should be.

Final Takeaways

The final results of our survey show the Johnson Prestige EHC plan with higher satisfaction ratings in all 21 out of 21 measurable factors. We awarded Green Shield a win in one area not covered by our survey: handheld technology, because they have a smart phone app and Johnson does not.

The significant question: “Would you recommend this plan to a friend?” was emblematic of the completely one-sided victory of Johnson over GSC. Barely more than a third of GSC users could imagine giving a recommendation, while nearly 9 out of 10 Johnson users were happy to do so.

Given these landslide results, one might surmise that our recommendation would be unequivocally for the plan we have sponsored and developed. Surely BCRTA would say that our plan is the only thing you should consider. But life isn’t that simple.

As we noted in the main report, there are some circumstances in which Green Shield might be a better option – notably where they cover certain medications that are not covered by the Johnson plan. So see if you are in that cohort of people where there would be a financial disadvantage to not use Green Shield. Check the plan coverages and don’t forget to factor in GS’s $200 per person deductible.

Most importantly to us, the survey’s ratings and comments have confirmed that retired educators like to be served well and with respect. As retirees, you like to get best value for money, and for your experience to be quick and reliable. On all these points, we are very proud to see that BCRTA’s Prestige Plan by Johnson has received remarkable ratings, not only higher than the immediate competition, but the industry in general. Our thanks to all those who faithfully serve retirees in this area.

This informative EHC Satisfaction Survey is yet another example of BCRTA in action: retirees helping their peers find the best options for a safe and happy retirement. Thanks to all who participated. Well done, everyone!